In medicine, shared decision making (SDM) is a process of patient-centered care in which both the physician and the patient (and family) contribute to the medical decision-making process. Physicians explain treatments and alternatives to patients to provide the resources and aids necessary for patients to choose the treatment option that best aligns with their personal needs. Auxiliary tools are also offered, which are specially designed with evidence-based medicine for the patients using graphical instructions and/or interactions to enable them to understand the disease, clinical course and treatment options better.
The contest of Shared Decision Making in Medicine has been held, since 2016, for two consecutive years by the Joint Commission of Taiwan. Our study aimed to provide information regarding the topics, diseases, use of tools by multidisciplinary teams, department distribution, and hospital level as a reference for the introduction of novel aids in the future.
We made descriptive analyses for the total of 107 winning entries (Table 1) from 2016 to 2017.
Winners came from 62 hospitals around Taiwan, including 57.0% of the winning entries in the medical centers. A total of 54 diseases were included in the SDM, with end-stage renal disease (8.4%) and respiratory failure (8.4%) tying for first place, followed by breast cancer (7.5%). The topics covered 35 themes (with multiple treatment options (26.2%) in the lead, followed by drugs (11.2%) and dialysis (8.4%)), involving 27 sub-specialty professionals (chest medicine, 11.2%; cardiology, 10.3%; and nephrology, 9.3%), and 13 tools. No significant differences were found between the winning entries and hospital level and/or auxiliary tools used.
The preliminary results of this study showed the current status of SDM and how evidence-based medicine was integrated with clinical experience in hospitals; however its efficacy needs to be evaluated further.
Patient or healthcare consumer involvement:
Good tools are the prerequisite to success. Auxiliary tools for SDM help physicians to communicate effectively with patients, and the contest helps to implement SDM.